Poor diet, inactivity and obesity have been linked to increased risks for a number of chronic diseases including cancer and cardiovascular diseases. Obesity and related health risk factors present in children are likely to persist into adulthood. The proposed research will investigate the relationships between televised advertisements for food, beverages, restaurants, and public service healthy diet and physical activity (HDPA) health promotion messages, and diet, physical activity, body mass index (BMI) and obesity among children and youth. The overwhelming majority (97.8%) of food product ads seen on television by American children are of poor nutritional content, being high in either sugar, fat or sodium. Most research has assessed the effect of advertising based on 1) evidence that TV watching time correlates with poor diet and/or obesity; or, 2) small- scale natural experiments that have focused on food requests or limited specific food choices which may have low external validity. The proposed project will build substantially on the previous literature. The specific aims are threefold: 1) examine the relationship between exposure to food, beverage and restaurant advertising (measured by total product exposure and nutritional content of ads using age and race-specific ratings) and children's and youths' dietary intake patterns (i.e., consumption of specific food products/groups and food away from home including fast food), diet quality (i.e., total caloric intake, % fat and % sugar in diet and overall healthy eating index), BMI and obesity; 2) examine the relationship between exposure to HDPA health promotion ads and diet, physical activity, BMI and obesity; and 3) examine the interactions between food- related and HDPA health promotion ads and neighborhood contextual factors (i.e., food prices and restaurant, food store, and physical activity-related outlet availability) and diet, activity and BMI/obesity. To accomplish these aims, the proposed research will conduct secondary data analyses, using a unique combination of four types of data: 1) television age- and race-specific ratings data for all food, beverage, restaurant, and anti- obesity advertisements, purchased from Nielsen Media Research for 106 designated media markets; 2) detailed nutritional content information about the advertised food products, 3) local area contextual data on food prices and outlet density measures; 4) data on population dietary intake, physical activity and measured height and weight from the National Health and Nutrition Examination Survey and the Early Childhood Longitudinal Study, two nationally representative population surveys one of which is longitudinal. The proposed project represents the most comprehensive exploration to date of the relationship between food, beverage, restaurant and HDPA health promotion advertising and diet, activity and BMI. Given the serious public health risk posed by poor diet, inactivity and obesity, this research can provide important information for policymakers and public health advocates about the potential effectiveness of regulating food television advertising to children and using TV media campaigns as policy tools for improving these health outcomes. PUBLIC HEALTH RELEVANCE: The proposed research will investigate the relationships between televised advertisements for food, beverages, restaurants, and public service healthy diet and physical activity health promotion messages, and diet, physical activity, body mass index and obesity among children and youth using market-level television ratings data and nationally representative cross-sectional and longitudinal population data. Given the serious public health risks including cancer and cardiovascular diseases posed by poor diet, inactivity and obesity, this research can provide important information for policymakers and public health advocates about the potential effectiveness of regulating food television advertising to children and using TV media campaigns as policy tools for improving these health outcomes.